Culos‐Reed 2006.

Study characteristics
Methods	Study design: randomized controlled cross‐over trial Number randomized: 38; 20 to the yoga group and 18 to the waiting list control group Study start and stop dates: not reported Length of intervention: 7 weeks Length of follow‐up: to end of intervention
Participants	Type cancer: mostly breast cancer (85%) Time since cancer diagnosis, mean (SD) months: 55.95 (54.30) months Time beyond active treatment: > 3 months Inclusion criteria: ≥ 18 years old not currently undergoing active treatment no additional health concerns a minimum of 3 months post‐treatment recovery from surgery as indicated by attending physician Eligibility criterion related to interest or ability to exercise, or both: Leisure Score Index used to assess baseline physical activity Exclusion criteria: heart condition hypertension or heart drugs bone and joint problems chest pain during activity or at rest loss of balance or dizziness  A medical examination was required for participation  Gender: 95% female Current age, mean (SD): 51.2 (10.3) years Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level: not reported SES: not reported Employment status: not reported Comorbidities: not reported Past exercise history: assessed using LSI of the Godin Leisure‐Time Activity Index, but not reported On hormone therapy: not reported
Interventions	20 participants assigned to the exercise group, including: yoga Type exercise (aerobic/anaerobic): aerobic Intensity of experimental exercise intervention: unclear, each individual worked at own exertion level Frequency: once per week Duration of individual sessions: 75 minutes Duration of exercise program: 7 weeks Total number of exercise sessions: 7 Format: group Facility: yoga studio Professionally led: instructor with Bachelor of Science degree in kinesiology and certified as a yoga instructor Adherence: not clearly reported, although it appears all completed the intervention 18 participants assigned to the control group, including: usual daily activities during waiting list Contamination of control group: no yoga reported
Outcomes	Primary outcome: QoL, measured on all 38 participants before and after the exercise intervention, using: Profile of Mood State, a 65‐item scale that assesses 6 affective dimensions: Tension–anxiety, depression–dejection, anger–hostility, vigor–activity, fatigue inertia, and confusion–bewilderment. It measures state (versus trait) attributes SOSI, which rates the frequency of stress‐related symptoms on a 5‐point scale ranging from never to frequently, during the past week. 10 subscale scores are derived from 95 individual items: (1) peripheral manifestations; (2) cardiopulmonary symptoms; (2a) symptoms of arousal, (2b) upper respiratory symptoms; (3) central neurologic symptoms; (4) gastrointestinal symptoms; (5) muscle tension; (6) habitual patterns (e.g. smoking, drinking, nail biting); (7) depression; (8) anxiety/fear; (9) emotional irritability; (10) cognitive disorganization EORTC QLQ‐C30, a 30‐item questionnaire includes 5 functional domains of QoL: Physical function (5 items), emotional function (4 items), cognitive function (2 items), social function (2 items), and role function (2 items). There are also several symptom scales: fatigue (3 items), pain (2 items), nausea and vomiting (2 items), and 1 item each for dyspnea, sleep disturbance, appetite, constipation, diarrhea, and financial difficulties. Finally, 2 items assess global QoL. 7 items are answered in a 'Yes–No' format, 21 items are evaluated on a 4‐point Likert‐type scale rating the presence of problems on a range from 'not at all' to 'very much'. Global 2 questions: 7‐point scale with the anchors of 'very poor' (1) to 'excellent' (7). Item scores are added together to calculate the subscale scores Secondary outcomes: LSI of the Godin Leisure‐Time Activity Index was used to assess previous physical activity levels. The LSI contains 3 questions that assess the frequency of mild, moderate, and strenuous physical activity performed for at least 15‐minute duration during free time in a typical week within the past month physical parameters: height, weight, and girth; grip strength, measured with a dynamometer (to the nearest 1.0 kg); flexibility measured by sit and reach measurements (to the nearest 0.5 cm); Rockport Walking Test was used as a measure of functional capacity via distance traveled in 6 minutes Adverse events: not reported Outcomes were measured at baseline and end of the intervention: exercise group: n = 20 at baseline, n = 18 after the intervention control group, n = 18 at baseline, n = 18 after the intervention Adverse events: none reported
Notes	Country: Canada Funding: Alberta Heritage Foundation for Medical Research Population Health Investigator Award; Canadian Institutes of Health Research New Investigator Award; University of Calgary Research Grant
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	The generation of the random sequence was not described
Allocation concealment (selection bias)	Unclear risk	Whether the treatment assignment was concealed from study personnel and participants was not described
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to blind the participants; however, it is unclear whether the outcome was influenced by a lack of masking
Blinding of outcome assessment (detection bias) All outcomes	High risk	Study personnel and outcome assessors were not masked or blinded to the study interventions
Incomplete outcome data (attrition bias) All outcomes	High risk	Two participants in the yoga group not included in the analyses. No reason given for the exclusion
Selective reporting (reporting bias)	Low risk	There appears to be no selective reporting of outcomes
Other bias	High risk	The small sample size and the lack of description of the recruitment and selection of participants could give rise to additional biases